The Lived Experience Of Patient Prudence In Health Care

June Larrabee, PhD, Associate Professor, Robert C. Byrd Health Sciences Center of West Virginia University School of Nursing, Morgantown, West Virginia, USA, email: jlarrabe@hsc.wvu.edu

Abstract:

Prudence, a concept included in a new model of quality (Larrabee, 1996), pertains to the individual's good judgment and skill in using personal resources to achieve realistic goals. The purpose of this phenomenological study was to describe the meaning of patient prudence in health care from the patient's perspective. The study participants were ten purposively-selected adult inpatients recruited from an acute care urban hospital in the Mid South. Inclusion criteria were ability to communicate in English, age 18 years or older, and experience with needing to m ake personal changes related to health or health care. Audiotaped interviews were conducted with participants responding to the question, 'What is the experience like for you when the doctor or nurse tells you to do something for your health that requires changes? "Interviews, which ranged in length from 15 to 30 minutes, continued until each participant exhausted discussion of his or her experience and no new themes appeared. Interviews were transcribed verbatim. Data were analyzed using Colaizzi's method. Seventy-seven significant statements were identified and, from their formulated meanings, seven themes emerged that were integrated into the following description of the fundamental structure of prudence. Prudence is a phenomenon in life's journey that is experienced within the complex world of a person's being and becoming with conscious or unconscious dynamic emotional and cognitive interplay among one's competing life goals, wants, and needs; behavioral alternatives; and limited resources. Believing the provider's actions are inherently beneficent and that the provider is sufficiently skilled, a person considers recommendations from a trusted provider about a valued health concern. With ever-present self-awareness of one's most treasured life goals, one faces a fork in the road of one's life journey, the challenge of making recommended changes for health. Persuaded that following the new path will lead to the realization of life goals, one embraces this path and begins traveling it. The embracing can be harmonious and willing when traveling that path is perceived as easy. But, when the traveling is a struggle because of competing priorities, inadequate resources, or great magnitude of the changes, the embracing can be resentfu1, sad, frustrating, discouraging, or fearful. For some, embracing the path means sacrificing pursuit of other valued life goals. Even when persuaded of the necessity for health, perceiving excessive struggle leads some to either reject the path or to construct a personally-acceptable alternative. For some, rejecting the path is an act of self-sacrifice, thought to be in the best interest of self or others. Whether embracing the path or not, perceiving lack of control over health is accompanied, for some, by reliance upon God and, at times, feelings of helplessness, depression, fear, and frustration. Combining an understanding of prudence with the skill of knowing the patient (Tanner, Benner, Chesla & Gordon, 1993) and a patient participatory approach (Cox, 1982; Beach, Campbell & Townes, 1979) may enable providers to be more effective in helping patients select and achieve their desired health outcomes. This partnership approach theoretically should help patients make choices about health behaviors within the whole context of their lives.

Repository Posting Date:

27-Oct-2011

Date of Publication:

27-Oct-2011

Conference Host:

Southern Nursing Research Society

Note:

This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC Field

Value

Language

dc.type.category

Abstract

en_US

dc.type

Presentation

en_GB

dc.title

The Lived Experience Of Patient Prudence In Health Care

en_GB

dc.contributor.author

Larrabee, June

en_US

dc.author.details

June Larrabee, PhD, Associate Professor, Robert C. Byrd Health Sciences Center of West Virginia University School of Nursing, Morgantown, West Virginia, USA, email: jlarrabe@hsc.wvu.edu

en_US

dc.identifier.uri

http://hdl.handle.net/10755/166076

-

dc.description.abstract

Prudence, a concept included in a new model of quality (Larrabee, 1996), pertains to the individual's good judgment and skill in using personal resources to achieve realistic goals. The purpose of this phenomenological study was to describe the meaning of patient prudence in health care from the patient's perspective. The study participants were ten purposively-selected adult inpatients recruited from an acute care urban hospital in the Mid South. Inclusion criteria were ability to communicate in English, age 18 years or older, and experience with needing to m ake personal changes related to health or health care. Audiotaped interviews were conducted with participants responding to the question, 'What is the experience like for you when the doctor or nurse tells you to do something for your health that requires changes? "Interviews, which ranged in length from 15 to 30 minutes, continued until each participant exhausted discussion of his or her experience and no new themes appeared. Interviews were transcribed verbatim. Data were analyzed using Colaizzi's method. Seventy-seven significant statements were identified and, from their formulated meanings, seven themes emerged that were integrated into the following description of the fundamental structure of prudence. Prudence is a phenomenon in life's journey that is experienced within the complex world of a person's being and becoming with conscious or unconscious dynamic emotional and cognitive interplay among one's competing life goals, wants, and needs; behavioral alternatives; and limited resources. Believing the provider's actions are inherently beneficent and that the provider is sufficiently skilled, a person considers recommendations from a trusted provider about a valued health concern. With ever-present self-awareness of one's most treasured life goals, one faces a fork in the road of one's life journey, the challenge of making recommended changes for health. Persuaded that following the new path will lead to the realization of life goals, one embraces this path and begins traveling it. The embracing can be harmonious and willing when traveling that path is perceived as easy. But, when the traveling is a struggle because of competing priorities, inadequate resources, or great magnitude of the changes, the embracing can be resentfu1, sad, frustrating, discouraging, or fearful. For some, embracing the path means sacrificing pursuit of other valued life goals. Even when persuaded of the necessity for health, perceiving excessive struggle leads some to either reject the path or to construct a personally-acceptable alternative. For some, rejecting the path is an act of self-sacrifice, thought to be in the best interest of self or others. Whether embracing the path or not, perceiving lack of control over health is accompanied, for some, by reliance upon God and, at times, feelings of helplessness, depression, fear, and frustration. Combining an understanding of prudence with the skill of knowing the patient (Tanner, Benner, Chesla & Gordon, 1993) and a patient participatory approach (Cox, 1982; Beach, Campbell & Townes, 1979) may enable providers to be more effective in helping patients select and achieve their desired health outcomes. This partnership approach theoretically should help patients make choices about health behaviors within the whole context of their lives.

en_GB

dc.date.available

2011-10-27T14:39:43Z

-

dc.date.issued

2011-10-27

en_GB

dc.date.accessioned

2011-10-27T14:39:43Z

-

dc.conference.host

Southern Nursing Research Society

en_US

dc.description.note

This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

-

All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.